Business Consultant, Reimbursement Policy & Claims Editing

About the Role

The Business Consultant, Reimbursement Policy & Claims Editing is responsible for translating moderately complex and varied business needs into application software requirements. This role requires full technical knowledge of most phases of systems and business analysis, with the ability to consider the business implications of applying technology to current and future business environments.

This is a hybrid position, requiring associates to be in-office 1-2 days per week to foster collaboration, while also providing flexibility for productivity and work-life balance. Alternate locations may be considered if candidates reside within commuting distance of an Elevance Health office in New York or Illinois.

How You Will Make An Impact

• May lead teams of analysts assigned to complex projects.
• Determines specific business application software requirements to address complex and varied business needs.
• Analyzes and designs solutions to address complex and varied business needs.
• Consults with business partners concerning application and implementation of technology.

Minimum Requirements

• Requires a BA/BS degree.
• Minimum of 8 years of business analysis experience, which should include analysis and project management.
• Any combination of education and experience that would provide an equivalent background will be considered.

Preferred Skills, Capabilities And Experiences

• Reimbursement Policy experience highly desired.
• Coding experience highly desired.
• Claims editing experience highly desired.
• SDLC experience highly desired.
• Knowledge of systems capabilities and business operations is strongly preferred.

About Elevance Health

Elevance Health is a leading health company committed to improving lives and communities and simplifying healthcare. A Fortune 25 company, we seek leaders passionate about impacting our members and the communities we serve. We operate with a Hybrid Workforce Strategy, requiring associates to work at an Elevance Health location at least once per week, unless specified as primarily virtual.

Our Culture & Benefits

At Elevance Health, we foster a culture designed for strategy advancement and personal/professional growth. Our values drive business outcomes and shared success. We offer market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, incentive bonus programs, comprehensive medical, dental, and vision benefits, short and long-term disability, 401(k) +match, stock purchase plan, life insurance, wellness programs, and financial education resources.

Please note: If this job is assigned to a Government Business Division entity, the role falls under a 'sensitive position' designation, subject to additional requirements like stringent background checks and specific data handling instructions.

Key skills/competency

• Reimbursement Policy
• Coding
• Claims Editing
• Business Analysis
• Project Management
• SDLC
• Systems Analysis
• Business Operations
• Requirements Gathering
• Stakeholder Consultation